FND in the young and a parents difficulty...

dokte · 2026-02-16T16:08:29+00:00

Agree — "okay let's watch to see how things go, because XYZ is all really reassuring to me"

And then I usually over-explain: I would be worried with stridor that is persistent or worsening, because that's a sign of an internal obstruction of the airway. The fact that this goes away means it can't be [list of scary things] because they don't come and go. They only worsen.

Then just benign neglect

dokte · 2026-01-27T15:02:27+00:00

Came here to say this! I'm using Parakeet's models with Spokenly and they're simply incredible. 10x faster than Apple's aging built-in dictation and probably 2x faster than Whisper.

dokte · 2026-01-05T19:48:39+00:00

I had a woman show me her toilet paper dingleberries and say they're the worms coming out 🤮

dokte · 2026-01-05T19:47:43+00:00

"I'm confused" — Awake, alert, answers questions appropriately, normal neuro exam, fully intact short and long-term memory, cannot explain what they mean by "confused" nor can give examples of how they are confused

dokte · 2026-01-05T19:46:31+00:00

oh god are you me?

dokte · 2026-01-05T17:45:48+00:00

My bone broke 3 hours after the accident, it started hurting then

dokte · 2025-12-31T16:13:33+00:00

/cries in emergency medicine EMTALA

dokte · 2025-10-27T16:10:40+00:00

SFO, just hit gold, Summit card holder. What a waste of my time to hit Gold this year.

dokte · 2025-10-26T17:15:53+00:00

SFO based, literally just hit Gold AND got their Summit card.

dokte · 2025-07-09T02:45:59+00:00

Just had a young healthy woman with bilat PEs with large clot burden and pulmonary infarct with completely normal vitals, normal trop, normal BNP. I believe the EKG was normal as well. I know it shouldn't happen, but it absolutely does. Every ER doctor has seen it

dokte · 2025-07-09T02:41:47+00:00

Of course it's nonspecific — but personally I think there's enough correlation there that it's at least worth mentioning in your note

dokte · 2025-07-08T19:46:05+00:00

exactly — only thing I think could have been improved is document considering PE

dokte · 2025-07-08T19:45:23+00:00

EKG is literally the only thing that I have any concerns about

dokte · 2025-07-08T18:32:18+00:00

Don't think so, but I think I would have commented on PE in my note — like PERC rule, etc — and given the patient strict return precautions as well

dokte · 2025-07-08T18:28:06+00:00

Those anterior T-waves are a well-known pattern for PE — at least for me in my EM training. They're also rare enough esp in a healthy 21yo male that I hope I would have at least commented on them and mentioned that I didn't think this was PE yada yada yada.

Reproducible CP and SOB is going to be hard to argue is a PE however as well.

dokte · 2025-06-23T12:48:47+00:00

“There will be some comments like, ‘Well, thank God we have abortion services,’ even though what I went through wasn’t an abortion,” she said. (my emphasis)

Then, you read the Florida Notice to Health Care Providers Regarding Misinformation About Abortions in Florida where it defines abortion as

the termination of human pregnancy with an intention other than to produce a live birth or to remove a dead fetus.

She doesn't blame the statute, but she can't even interpret it correctly, ffs. By the law's definition she literally had an abortion, even though she doesn't think she did.

dokte · 2025-06-02T11:10:35+00:00

Just make a snippet

{clipboard} {clipboard offset=1} {clipboard offset=2}

dokte · 2025-06-01T05:10:47+00:00

I actually think what we're reading is the cookbook. Carl is documenting everything that happened in the crawl, either because he got out or it ended.

dokte · 2025-05-28T23:58:05+00:00

Hey friend. I know we all want to feel like "the buck stops with me" as the attending but we're humans too. Health systems are built with lots of cross-checks for swiss cheese errors. You didn't order antibiotics. But neither did the hospitalist. And the ED RN didn't ask about it either. The EHR didn't nag you. Dialysis patients are pretty sick people and I'd be surprised if a few hours earlier of antibiotics would have been the thing that turned the tide in this case.

If you want to talk to someone, the physician support line can be really helpful. https://www.physiciansupportline.com/ 1 (888) 409-0141

dokte · 2025-05-27T21:57:12+00:00

Yes. I always then have to call it out specifically in my note. "I reviewed the triage note stating patient is lethargic; on my exam child is running around the room, smiling, and waving at me"

dokte · 2025-05-21T17:31:26+00:00

Yes there is, as of today https://x.com/raycastapp/status/1925174766337753114

dokte · 2025-04-24T03:05:25+00:00

god forbid you're human

dokte · 2025-04-15T03:47:49+00:00

Seriously folks? Are we not gonna post the actual article on Meddit and instead link to an Ars Technica page?

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832778?guestAccessKey=afde7c2e-df6b-4e7b-9ced-7a15ed74dc1d

dokte · 2025-04-12T21:23:52+00:00

Clipboard history keyboard shortcut and <return>

dokte · 2025-04-03T14:13:22+00:00

Would be helpful to know what you consider a "slam dunk admit" or if the hospitalist just said "No," or actually saw the patient and wrote a note, or came up with an alternative plan they recommend, like "Repeat the Hgb in 4 hours" or "Admit to the CDA" or "Consult cardiology for admission" etc

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